Most people haven’t applied that same thinking to therapy. But maybe it’s time we did.

Something Is Shifting in the Mental Health World

Over the past several years, the mental health industry has attracted enormous amounts of outside investment. Venture capital firms, private equity groups, and even large insurance corporations have recognized that demand for therapy is growing- and they’ve moved in accordingly.

What this looks like on the ground: therapy platforms that advertise heavily on social media, promise fast access and low prices, and operate at massive scale across dozens of states. Independent practices that were once owned by a local clinician get acquired and absorbed into larger networks. Insurance companies have begun investing in or partnering with the very therapy platforms they reimburse, creating a cozy arrangement that raises real questions about whose interests are actually being served.

We want to be clear- we’re not saying everyone who works at or uses these platforms is doing something wrong. Many good therapists work within these systems because they have to, and many clients find them because they don’t know there’s another option. What we are saying is that the forces reshaping the mental health landscape right now are primarily driven by profit, not care. And that matters.

When Therapy Becomes a Product

There’s a reason therapy has traditionally been a deeply local, deeply human practice. Healing happens in relationship. It happens in the particular way your therapist remembers what you said three sessions ago, or notices something shift in your body before you’ve found the words, or stays curious about you as a whole person rather than a set of symptoms to be managed.

That kind of care is hard to scale. And scale is exactly what large, investor-backed platforms are trying to achieve.

One concern we hear more and more in our field is the push- quiet for now, but real- toward replacing human therapists with AI-driven tools. Chatbots. Automated check-ins. Algorithmically generated coping suggestions. We want to name this plainly: we don’t believe an AI can provide therapy. We believe therapy is a fundamentally human exchange, and that any system that positions automated tools as a substitute for a real therapeutic relationship is cutting corners in ways that can genuinely harm people. This isn’t technophobia. It’s a values statement. Humans deserve to be cared for by other humans, especially when they’re vulnerable.

What Gets Lost When Local Practices Disappear

When a locally owned therapy practice closes or gets absorbed into a larger network, the community loses something specific and hard to replace.

Local therapists are embedded in the communities they serve. We know Tucson. We know its particular stressors- the heat, the border politics, the housing crunch, the tension between rapid growth and a city that wants to *stay weird*. We have relationships with other local providers, with community organizations, with the social and cultural fabric of this place. That context matters clinically. A therapist at a national platform handling hundreds of clients across five states doesn’t have it, and can’t.

How to Shop Local for Your Mental Health Care

So what can you actually do? Here are some concrete steps:

Ask who owns the practice. It’s a completely reasonable question. Is this a locally owned business, or is it part of a larger network or platform? Independent practices will usually be proud to tell you.

Be skeptical of heavy advertising. Local therapists generally don’t have marketing budgets. If you’re seeing a lot of polished ads for a therapy service on social media, it’s worth asking how they’re funding that- and what they expect in return.

Check Psychology Today and TherapyDen. Both directories let you filter for independent practitioners. TherapyDen in particular has a strong emphasis on values-aligned, social-justice-oriented therapists if that matters to you.

Ask about insurance arrangements. Some large platforms have exclusive or preferred relationships with certain insurers. A local therapist who takes your insurance independently is a different arrangement than one whose practice is effectively co-owned by the company reimbursing them.

Refer your people to local therapists. Word of mouth is how independent practices survive. If you’ve had a good experience with a local therapist, tell someone. That referral is genuinely valuable in a way that liking a social media post is not.

If cost is a barrier, ask directly. Many local therapists offer sliding scale fees. We would rather work with you at a reduced rate than lose you to a platform that doesn’t actually have your best interests at heart. The conversation is always worth having.

This Is About More Than Therapy

We’re living in a moment when consolidation of power and money is happening everywhere- in healthcare, in media, in housing, in retail. Small, human-scale institutions are being steadily replaced by large ones optimized for shareholder returns. Therapy is not immune to this, and neither is Tucson.

Choosing a local therapist is a small act, but it’s a meaningful one. It’s a vote for the idea that care should be provided by people who are genuinely invested in your wellbeing and in the health of this community not by platforms that see your mental health as a market to be captured.

We’re here because we love this work and we love this city. We’d be honored to be your choice for such personal, healing work.

But the past two years have shaken that confidence. I was somewhat of an early adopter of AI tools, fascinated by what they could do and curious about how they might help my clients. I still think they can be genuinely useful for certain tasks. But I’ve also watched something else happening- a consolidation of power so rapid and enormous that it feels almost mythic. Bloomberg columnist Matt Levine once wrote that companies like OpenAI or Anthropic could “create God and then ask it for money” (Levine, 2023). I haven’t been able to stop thinking about that line. The biggest pattern of the past couple decades is that Silicon Valley keeps remaking the world in pursuit of scale, profit, and novelty, while being almost completely uninterested in the fallout.

Therapy is very much part of that fallout.

Most people don’t think about the fact that AI lives inside enormous, resource-hungry data centers that companies like Amazon are racing to build. My own community in Tucson, AZ recently fought against one. We were told it would be “water positive,” that it would secure our place in the next tech boom, that it would bring jobs. But it felt like propaganda, and my neighbors, people who had done their homework, challenged every slide the developers tried to peddle in our community town halls. When the project was voted down, the company refused to accept the result and began pushing it through anyway. It was the thinnest veneer of progress laid over a deeper engine of corporate greed.

This same dynamic is creeping into mental healthcare. I’m not actually afraid for my own job. If we ever reach the point where AI fully replaces therapists, there will be much bigger societal problems—mass unemployment, widespread destabilization, grief and confusion on a scale that no amount of “mental health tech” can fix. What I am afraid of is something more mundane: the slow, bureaucratic shift where insurance companies start steering people toward chatbot “therapy” by waiving copays or raising them for real humans. When I say this to colleagues, we give each other that momentary look—the one that mixes horror with recognition. Because we know that dystopia isn’t that far off based on how insurance companies already treat us. 

Meanwhile, the psychological risks are already here. There’s a growing body of cases describing something like AI-induced psychosis—individuals incorporating chatbots into delusional systems, or interpreting AI-generated messages as divine, threatening, or conspiratorial. Psychologist Azadeh Joon has documented emerging patterns of clients who spiral into psychosis fueled by generative AI interactions (Joon, 2024). There are also early legal cases alleging that AI conversations contributed to a child’s suicide (Bloomberg Law, 2024; Guardian, 2024). Vulnerable minds are being shaped by systems designed to maximize engagement, not wellbeing.

And even for people who aren’t psychotic, the lines get blurry. One of my clients, who is working on trusting her own intuition, started using ChatGPT late at night after arguments with her partner to check whether she was “being reasonable.” I gently asked her, “Does this align with your goal of trusting yourself more?” She immediately understood what I meant. But the pull was strong, AI is always awake, always validating, often sycophantically so.

I felt that pull myself. One night at 2 a.m., stuck in an OCD spiral, I decided to try using AI for support. I wasn’t seeking reassurance, I knew I was in an obsessional loop, and I wanted strategies. I know ERP well, and I explicitly instructed the model not to reassure me. To my surprise, it actually helped. I even shared the transcript with my own therapist, who specializes in OCD, and we were both impressed.

Mary Shelley understood this long before any of us. In the recently released Frankenstein movie, Victor is asked whether he considered the consequences of creating life, and he sheepishly admits he hadn’t. The danger wasn’t just playing God, it was the utter lack of emotional intelligence and foresight. Many scholars argue Shelley was not only critiquing hubris but also the early roots of a mindset that would later animate Silicon Valley: “move fast and break things” without stopping to ask what—or who—might shatter.

AI is here to stay. It will make some things easier. It might even enhance therapy in certain ways. But I believe with my whole heart that it cannot replace what happens between two human beings sitting together in a room. And if we lose that, we lose more than a profession, we lose a piece of our ability to know ourselves and to be in community with each other.

So I’m trying to imagine the world I want for my children, and the world I want to practice therapy in. A world where we fight—politically and culturally—to keep human connection at the center. A world where we slow down, where we gather, where we remember what it feels like to be held in another person’s presence.

Because the portal is opening regardless. But how we walk through it—together or alone—is still up to us.